CLHIA launches anti-fraud campaign

The Canadian Life and Health Insurance Association (CLHIA) announced on Oct. 31 the launch of a campaign to raise consumer awareness regarding health and dental benefits fraud.

The CLHIA says benefits fraud is when an individual intentionally submits false or misleading information about the health or dental benefits they received under their employer’s benefit plan.

Many do not realize that benefits fraud is a crime

"Benefits fraud is far more widespread than it should be, in part because many people don't understand that it is an actual crime," said president and CEO of the CLHIA, Stephen Frank. "Most people think that, if you are caught, you would just repay the money. In fact, you could not only lose your benefits, but also your job and, in some cases, end up with a criminal record and even go to jail."

An Environics Research survey conducted for the CLHIA showed that 75 per cent of Canadians incorrectly believe that the only punishment for benefits fraud is having to pay higher premiums, or being forced to reimburse claim payments.

Increasing evidence that organized crime is involved

While certain individuals did not understand they were engaging in fraud, the CLHIA said the industry is increasingly seeing evidence of organized crime or unscrupulous service providers getting involved and reassuring their victims on the legitimacy of their practices. Frank says the increase in such schemes is "resulting in companies having to lay off large numbers of staff, and that can have a huge negative impact. That is why we believe a campaign like this is timely and necessary."